96% scorer inadequately treated for dog bite, succumbs to rabies

PUNE: Having scored 96% in Class X board exams, Deepak Mohalkar had been looking forward to June 21 — the day he was to collect his mark sheet. Thanks to his high marks, he was certain of getting admission in the science stream and eventually become an engineer. Instead, on June 20, Mohalkar was diagnosed with rabies and on June 23, he succumbed to infection caused by a six-month-old inadequately treated dog bite.


“A neighbour’s puppy had bitten Deepak on the left leg six months ago. Though a deep wound, it had healed with treatment. And we had forgotten about the incident. However, he started developing symptoms a week ago. His condition deteriorated and he was diagnosed with rabies on June 20 — just a day before his mark sheet was released. On June 23, Deepak died at the Pune Municipal Corporation-run Naidu Infectious Disease Hospital,” said his brother Dattatray.

Incidentally, Mohalkar had sought prompt treatment from a private medical practitioner in his village and had visited a primary health centre (PHC) a few kilometres away to get the rabies vaccine. However, he did not get the fast-acting rabies antibodies (immunoglobulins) that can immediately deactivate the virus.

Mohalkar’s case exposes the poor shape of the public healthcare system in the state’s rural areas. The Naidu hospital reports 20-25 cases each year, most of them from rural Maharashtra.

When contacted, Sanjeev Kamble, the director of the state health department, said, “Rabies immunoglobulins are only available at bigger institutions like state-run district hospitals and medical colleges. A PHC only has the anti-rabies vaccines. Deepak should have been referred to a bigger institute for complete treatment.”

“Deepak was given the anti-rabies vaccine at the PHC. But he was not given the rabies antibodies. We got to know about it later. Had he been given the immunoglobins then, Deepak would not have died,” Dattatray said.

Most private practitioners in rural Maharashtra are not aware of the need to administer both the vaccine and the immunoglobulin in grade III bites — where the integrity of the skin is breached drawing blood.

“It has been our observation that dog bite patients coming from the rural areas are almost always inadequately treated. In most cases, they don’t get the fast-acting rabies antibodies called immunoglobulins — which can immediately deactivate the virus. The availability of immunoglobulin in the rural areas is also limited. Deepak was also not administered the life-saving drug,” said Sudhir Patsute, the incharge of Naidu Hospital. Medical experts said people also had the tendency to dismiss bites of puppies as innocuous, which could be dangerous.

“The awareness is abysmally low at the state government-run rural hospitals and PHCs. Most of these healthcare units don’t even have immunoglobulins for patients,” said activist and medical practitioner Sanjay Dabhade. Even in urban areas, only 10% of government clinics provide complete treatment — both vaccine and immunoglobulin.

“Deepak got 95.6% and wanted to prepare for CET. A private tutorial in Ahmednagar had even waived off the fees for him,” said his teacher Sunil Takle, of Nageshwar Vidyalaya in Nagalwad.